We take a look at the five critical illnesses which research findings from Gen Re’s “2012 Dread Disease Survey” shows that over 90 per cent of all severe stage claims received by life insurers are for. The markets covered by Gen Re’s survey included Hong Kong, Malaysia, Australia, United Kingdom and Singapore, and these five important or core CIs are found within the standard 37 CIs.

The five are:

Major Cancers

Heart Attack of Specified Severity

Coronary Artery By-pass Surgery

Stroke

Kidney Failure

Major Cancers

Old Definition (2003):

Major Cancers

A malignant tumour characterised by the uncontrolled growth and
spread of malignant cells with invasion and destruction of normal tissue. This
diagnosis must be supported by histological evidence of malignancy and
confirmed by an oncologist or pathologist.

The following are excluded:

Tumours showing the malignant changes of
carcinoma-in-situ and tumours which are histologically described as
pre-malignant or non-invasive, including, but not limited to: Carcinoma-in-Situ
of the Breasts, Cervical Dysplasia CIN-1, CIN-2 and CIN-3;

Hyperkeratoses, basal cell and squamous skin
cancers, and melanomas of less than 1.5mm Breslow thickness, or less than Clark
Level 3, unless there is evidence of metastases;

Prostate cancers histologically described as TNM
Classification T1a or T1b or Prostate cancers of another equivalent or lesser
classification, T1N0M0 Papillary micro-carcinoma of
the Thyroid less than 1 cm in diameter, Papillary micro-carcinoma of the
Bladder, and Chronic Lymphocytic Leukaemia less than RAI Stage 3; and

All tumours in the presence of HIV infection.

New Definition (2014):

Major Cancers

A malignant tumour positively diagnosed with histological
confirmation and characterized by the uncontrolled growth of malignant cells
with invasion and destruction of normal tissue.

The term malignant tumour includes leukemia, lymphoma and
sarcoma.

For the above definition, the following are excluded:

All tumours which are histologically classified as any
of the following:

Pre-malignant;

Non-invasive;

Carcinoma-in-situ;

Having borderline malignancy;

Having any degree of malignant potential;

Having suspicious malignancy;

Neoplasm of uncertain or unknown behavior; or

Cervical Dysplasia CIN-1, CIN-2 and CIN-3;

Any non-melanoma skin carcinoma unless there is evidence
of metastases to lymph nodes or beyond;

Malignant melanoma that has not caused invasion beyond
the epidermis;

All Prostate cancers histologically described as T1N0M0
(TNM Classification) or below; or Prostate cancers of another equivalent or
lesser classification;

All tumours of the Urinary Bladder histologically
classified as T1N0M0 (TNM Classification) or below;

All Gastro-Intestinal Stromal tumours histologically
classified as T1N0M0 (TNM Classification) or below and with mitotic count of
less than or equal to 5/50 HPFs;

Chronic Lymphocytic Leukaemia less than RAI Stage 3; and

All tumours in the presence of HIV infection.

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Heart Attack

Old Definition:

Heart Attack

Death of a portion of the heart
muscle arising from inadequate blood supply to the relevant area. This
diagnosis must be supported by three or more of the following five criteria
which are consistent with a new heart attack:

History of typical chest pain;

New electrocardiogram (ECG)
changes proving infarction;

Diagnostic elevation of
cardiac enzyme CK-MB;

Diagnostic elevation of
Troponin (T or I);

Left ventricular ejection
fraction less than 50% measured 3 months or more after the event.

New Definition:

Heart Attack of Specified
Severity

Death of heart muscle due to obstruction of blood flow,
that is evident by at least three of the following criteria proving the
occurrence of a new heart attack:

History of typical chest pain;

New characteristic electrocardiographic changes; with
the development of any of the following: ST elevation or depression, T wave
inversion, pathological Q waves or left bundle branch block;

Elevation of the cardiac biomarkers, inclusive of CKMB
above the generally accepted normal laboratory levels or Cardiac Troponin T or
I at 0.5ng/ml and above;

Imaging evidence of new loss of viable myocardium or new
regional wall motion abnormality. The imaging must be done by Cardiologist
specified by the Company.

For the above definition, the following are excluded:

Angina;

Heart attack of indeterminate age; and

A rise in cardiac biomarkers or Troponin T or I
following an intra-arterial cardiac procedure including, but not limited to,
coronary angiography and coronary angioplasty.

Explanatory
note: 0.5ng/ml = 0.5ug/L = 500pg/ml

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Coronary Artery By-pass Surgery

Old definition:

Coronary Artery By-pass Surgery

The actual undergoing of open-chest surgery to
correct the narrowing or blockage of one or more coronary arteries with bypass
grafts. This diagnosis must be supported by angiographic evidence of
significant coronary artery obstruction and the procedure must be considered
medically necessary by a consultant cardiologist.

Angioplasty
and all other intra arterial, catheter based techniques, ‘keyhole’ or laser
procedures are excluded.

New
Definition:

Coronary
Artery By-pass Surgery

The actual undergoing of open-chest surgery or Minimally
Invasive Direct Coronary Artery Bypass surgery to correct the narrowing or
blockage of one or more coronary arteries with bypass grafts. This diagnosis
must be supported by angiographic evidence of significant coronary artery
obstruction and the procedure must be considered medically necessary by a
consultant cardiologist.

Angioplasty
and all other intra arterial, catheter based techniques, ‘keyhole’ or laser
procedures are excluded.

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Stroke

Old
definition:

Stroke

A cerebrovascular incident
including infarction of brain tissue, cerebral and subarachnoid haemorrhage,
cerebral embolism and cerebral thrombosis. This diagnosis must be supported by
all of the following conditions:

Evidence of permanent
neurological damage confirmed by a neurologist at least 6 weeks after the
event; and

Findings on Magnetic Resonance
Imaging, Computerised Tomography, or other reliable imaging techniques
consistent with the diagnosis of a new stroke.

The following are excluded:

Transient Ischaemic Attacks;

Brain damage due to an
accident or injury, infection, vasculitis, and inflammatory disease;

Vascular disease affecting the
eye or optic nerve; and

Ischaemic disorders of the
vestibular system.

New Definition:

Stroke

A cerebrovascular incident including infarction of brain
tissue, cerebral and subarachnoid haemorrhage, intracerebral embolism and
cerebral thrombosis resulting in permanent neurological deficit with persisting
clinical symptoms. This diagnosis must be supported by all of the following conditions:

Evidence of permanent clinical neurological deficit
confirmed by a neurologist at least 6 weeks after the event; and

Findings on Magnetic Resonance Imaging, Computerised
Tomography, or other reliable imaging techniques consistent with the diagnosis
of a new stroke.

The following are excluded:

Transient Ischaemic Attacks;

Brain damage due to an accident or injury, infection,
vasculitis, and inflammatory disease;

Vascular disease affecting the eye or optic nerve; and

Ischaemic disorders of the vestibular system.

Permanent means expected to last throughout the lifetime
of the Life Assured.

Permanent
neurological deficit with persisting clinical symptoms means symptoms of
dysfunction in the nervous system that are present on clinical examination and
expected to last throughout the lifetime of the Life Assured. Symptoms that are
covered include numbness, paralysis, localized weakness, dysarthria (difficulty
with speech), aphasia (inability to speak), dysphagia (difficulty swallowing),
visual impairment, difficulty in walking, lack of coordination, tremor,
seizures, dementia, delirium and coma.